Urohidrosis as an overlooked cooling mechanism in long-legged birds

Behavioural thermoregulation could buffer the impacts of climate warming on vertebrates. Specifically, the wetting of body surfaces and the resulting evaporation of body fluids serves as a cooling mechanism in a number of vertebrates coping with heat. Storks (Ciconiidae) frequently excrete onto their legs to prevent overheating, a phenomenon known as urohidrosis. Despite the increasingly recognised role of bare and highly vascularised body parts in heat exchange, the ecological and evolutionary determinants of urohidrosis have been largely ignored. We combine urohidrosis data from a scientifically curated media repository with microclimate and ecological data to investigate the determinants of urohidrosis in all extant stork species. Our phylogenetic generalised linear mixed models show that high temperature, humidity and solar radiation, and low wind speed, promote the use of urohidrosis across species. Moreover, species that typically forage in open landscapes exhibit a more pronounced use of urohidrosis than those mainly foraging in waterbodies. Substantial interspecific variation in temperature thresholds for urohidrosis prevalence points to different species vulnerabilities to high temperatures. This integrated approach that uses online data sources and methods to model microclimates should provide insight into animal thermoregulation and improve our capacity to make accurate predictions of climate change’s impact on biodiversityinfo:eu-repo/semantics/publishedVersio

Factores relacionados con adherencia a un programa de rehabilitación

Lack of completion of a rehabilitation program on the part of the patient is reflected in the loss of achievements. For this reason it is necessary to know the factors that can lead to loss of continuity in the reatment. The aims of this study are: to determine the factors involved in patients´ adherence to an integral rehabilitation program and to describe and analyze the reasons that patients had, to not follow the recommendations of an integral rehabilitation program. Materials and methods: a qualitative study of paradigmatic axial-coding analysis was conducted, based on 7 focus group including therapists, patients and adults, children, adolescents’ relatives. Results. Different groups interviewed showed a wide range of concepts related to rehabilitation. Both relatives and patients agreed on the lack of time and fatigue as the main difficulties to perform the activities recommended by the therapists. As for the therapists, there are differences with respect to the concepts about adherence since in some cases the definitions are closer to patients’ attendance and obedience than to a patient’s active participation. Conclusions. The results indicate that a program that aims to improve adherence among patients must have a biopsychosocial approach. Knowing the conditions associated with more or less adherence to the program will allow to improve the effectiveness of the interventions implying collaboration instructional follow-up. It will also allow to overcome the difficulties that may depend upon the therapeutic team, the rehabilitation program design or the institution itself.  La falta de cumplimiento por parte del paciente de un programa de rehabilitación se refleja en la pérdida de logros obtenidos, lo cual hace necesario conoce los factores que pueden llevar a pérdida de continuidad del tratamiento. Los objetivos son determinar los factores que intervienen en la adherencia de los pacientes a un programa de rehabilitación integral, describir y analizar las razones planteadas por los pacientes cuando fallan en el cumplimiento de las recomendaciones en un programa de rehabilitación integral. Materiales y métodos: se realizó un estudio cualitativo de tipo análisis paradigmático con codificación axial, basado en siete grupos focales que incluían terapeutas, pacientes, familiares de pacientes adultos, de pacientes niños y de pacientes adolescentes. Resultados: se encontró que familiares y pacientes coinciden en que la falta de tiempo y el cansancio son las principales dificultades para desarrollar las actividades propuestas por los terapeutas. En cuanto a los terapeutas, hay diferencias en los conceptos sobre adherencia ya que en algunos casos las definiciones se acercan más al cumplimiento y la obediencia que a una participación activa del paciente en su proceso. Conclusiones: un programa que pretenda mejorar la adherencia en los pacientes debe tener un enfoque bio-psico-social. Conocer las condiciones que se asocian a una mayor o menor adherencia permite mejorar la efectividad de las intervenciones que implican colaboración y seguimiento instruccional por parte del paciente y eliminar las dificultades que puedan depender del equipo terapéutico, del diseño del programa de rehabilitación o de la institución propiamente dicha

Multidrug resistant pulmonary tuberculosis treatment regimens and patient outcomes: an individual patient data meta-analysis of 9,153 patients.

Treatment of multidrug resistant tuberculosis (MDR-TB) is lengthy, toxic, expensive, and has generally poor outcomes. We undertook an individual patient data meta-analysis to assess the impact on outcomes of the type, number, and duration of drugs used to treat MDR-TB

Primera aproximación al uso de la ocupación del tapir (Tapirella bairdii Gill, 1865) como indicador de la integridad ecológica en la Reserva de la Biosfera Maya, Guatemala

La Reserva de la Biosfera Maya (RBM) es un área protegida de relevancia nacional, regional y mundial por la diversidad biológica  asociada  y  los  beneficios  que  se  obtienen  de  esta.  En  su  plan  maestro  se  plantea  el  conjunto  de  elementos  de conservación a partir de los cuales se orientan estrategias y se evalúa la efectividad de manejo de dicha reserva, entre los cuales se incluye a Tapirella  bairdii  (tapir), por lo que es importante contar con un monitoreo de esta especie como una  herramienta para la administración de esta reserva. En el 2015 se inició el desarrollo de un protocolo de monitoreo basado en la estimación de  la  probabilidad de  ocupación  y el  presente  estudio constituye  la  continuación de  esta  iniciativa  a  través de la implementación de las  temporadas  de muestreo en 2017 y 2018. Se registró la presencia del tapir en cinco zonas núcleo de la RBM empleando trampas cámara y se estimó la probabilidad de ocupación. Los valores estimados sugieren una relación  de la ocupación con la integridad ecológica, en la cual hay una mayor ocupación en áreas con menor perturbación. Se generaron modelos con cinco covariables relacionadas con amenazas potenciales, sin embargo fue el modelo nulo el que se  seleccionó  de  acuerdo  al  criterio  definido.  Los  resultados  sugieren  que  la  integridad  ecológica  en  las  áreas  de  estudio  está siendo afectada  como consecuencia  de  las presiones antrópicas por lo que  es necesario el  fortalecimiento de  aquellas con menores valores de ocupación.

The Diagnostic Sensitivity of Dengue Rapid Test Assays Is Significantly Enhanced by Using a Combined Antigen and Antibody Testing Approach

Dengue is a serious public health concern with around 3 billion people at risk of infection. Severe forms of the infection can be fatal and with no licensed vaccine or effective therapeutic currently available, early detection is important to assist with the clinical management of symptoms. Isolation of the virus and the detection of viral RNA using RT-PCR are commonly used methods for early diagnosis but are time-consuming, expensive and require skilled operation. Rapid immunochromatographic tests (ICT) are relatively simple, inexpensive and easy to perform at or near the point of care. Here, we report on the clinical performance of a new rapid ICT for the non-structural protein 1 (NS1) of dengue virus, a marker of acute infection. At two clinical study sites, NS1 was detected in 60–70% of laboratory-confirmed dengue cases and specificity of the test was >95%. We have also shown that a combined testing approach for both circulating NS1 antigen and antibody responses to the glycoprotein E of the virus can significantly improve diagnostic sensitivity compared to the detection of NS1 alone. Importantly, the combined antigen and antibody testing approach also provides an expanded window of detection from as early as day 1 post-onset of illness

Integrative Analysis of Clinicopathological Features Defines Novel Prognostic Models for Mantle Cell Lymphoma in the Immunochemotherapy Era: A Report from The North American Mantle Cell Lymphoma Consortium

BACKGROUND: Patients with mantle cell lymphoma (MCL) exhibit a wide variation in clinical presentation and outcome. However, the commonly used prognostic models are outdated and inadequate to address the needs of the current multidisciplinary management of this disease. This study aims to investigate the clinical and pathological features of MCL in the immunochemotherapy era and improve the prognostic models for a more accurate prediction of patient outcomes. METHODS: The North American Mantle Cell Lymphoma Project is a multi-institutional collaboration of 23 institutions across North America to evaluate and refine prognosticators for front-line therapy. A total of 586 MCL cases diagnosed between 2000 and 2012 are included in this study. A comprehensive retrospective analysis was performed on the clinicopathological features, treatment approaches, and outcomes of these cases. The establishment of novel prognostic models was based on in-depth examination of baseline parameters, and subsequent validation in an independent cohort of MCL cases. RESULTS: In front-line strategies, the use of hematopoietic stem cell transplantation was the most significant parameter affecting outcomes, for both overall survival (OS, p \u3c 0.0001) and progression-free survival (PFS, p \u3c 0.0001). P53 positive expression was the most significant pathological parameter correlating with inferior outcomes (p \u3c 0.0001 for OS and p = 0.0021 for PFS). Based on the baseline risk factor profile, we developed a set of prognostic models incorporating clinical, laboratory, and pathological parameters that are specifically tailored for various applications. These models, when tested in the validation cohort, exhibited strong predictive power for survival and showed a stratification resembling the training cohort. CONCLUSIONS: The outcome of patients with MCL has markedly improved over the past two decades, and further enhancement is anticipated with the evolution of clinical management. The innovative prognostic models developed in this study would serve as a valuable tool to guide the selection of more suitable treatment strategies for patients with MCL

Impact of Detectable Monoclonal Protein at Diagnosis on Outcomes in Marginal Zone Lymphoma: A Multicenter Cohort Study

Given the paucity of data surrounding the prognostic relevance of monoclonal paraprotein (M-protein) in marginal zone lymphoma (MZL), we sought to evaluate the impact of detecting M-protein at diagnosis on outcomes in patients with MZL in a large retrospective cohort. The study included 547 patients receiving first-line therapy for MZL. M-protein was detectable at diagnosis in 173 (32%) patients. There was no significant difference in the time from diagnosis to initiation of any therapy (systemic and local) between the M-protein and no M-protein groups. Patients with M-protein at diagnosis had significantly inferior progression-free survival (PFS) compared with those without M-protein at diagnosis. After adjusting for factors associated with inferior PFS in univariate models, presence of M-protein remained significantly associated with inferior PFS (hazard ratio, 1.74; 95% confidence interval, 1.20-2.54; P = .004). We observed no significant difference in the PFS based on the type or quantity of M-protein at diagnosis. There were differential outcomes in PFS based on the first-line therapy in patients with M-protein at diagnosis, in that, those receiving immunochemotherapy had better outcomes compared with those receiving rituximab monotherapy. The cumulative incidence of relapse in stage 1 disease among the recipients of local therapy was higher in the presence of M-protein; however, this did not reach statistical significance. We found that M-protein at diagnosis was associated with a higher risk of histologic transformation. Because the PFS difference related to presence of M-protein was not observed in patients receiving bendamustine and rituximab, immunochemotherapy may be a preferred approach over rituximab monotherapy in this group and needs to be explored further

Impact of Early Relapse within 24 Months after First-Line Systemic Therapy (POD24) on Outcomes in Patients with Marginal Zone Lymphoma: A US Multisite Study

Progression of disease within 24 months (POD24) from diagnosis in marginal zone lymphoma (MZL) was shown to portend poor outcomes in prior studies. However, many patients with MZL do not require immediate therapy, and the time from diagnosis-to-treatment interval can be highly variable with no universal criteria to initiate systemic therapy. Hence, we sought to evaluate the prognostic relevance of early relapse or progression within 24 months from systemic therapy initiation in a large US cohort. The primary objective was to evaluate the overall survival (OS) in the two groups. The secondary objective included the evaluation of factors predictive of POD24 and the assessment of cumulative incidence of histologic transformation (HT) in POD24 versus non-POD24 groups. The study included 524 patients with 143 (27%) in POD24 and 381 (73%) in non-POD24 groups. Patients with POD24 had inferior OS compared to those without POD24, regardless of the type of systemic therapy received (rituximab monotherapy or immunochemotherapy) at diagnosis. After adjusting for factors associated with inferior OS in the univariate Cox model, POD24 remained associated with significantly inferior OS (HR = 2.50, 95% CI = 1.53-4.09, p = 0.0003) in multivariable analysis. The presence of monoclonal protein at diagnosis and those who received first-line rituximab monotherapy had higher odds of POD24 on logistic regression analysis. Patients with POD24 had a significantly higher risk for HT compared to those without POD24. POD24 in MZL might be associated with adverse biology and could be used as an additional information point in clinical trials and investigated as a marker for worse prognosis

Vertical Boundary Mixing Events during Stratification Govern Heat and Nutrient Dynamics in a Windy Tropical Reservoir Lake with Important Water-Level Fluctuations: A Long-Term (2001–2021) Study

hysical processes play important roles in controlling eutrophication and oligotrophication. In stratified lakes, internal waves can cause vertical transport of heat and nutrients without breaking the stratification, through boundary mixing events. Such is the case in tropical Valle de Bravo (VB) reservoir lake, where strong diurnal winds drive internal waves, boundary mixing, and hypolimnetic warming during stratification periods. We monitored VB during 21 years (2001–2021) when important water-level fluctuations occurred, affecting mixing and nutrient flux. Stability also varied as a function of water level. Hypolimnetic warming (0.009–0.028 °C day−1) occurred in all the stratifications monitored. We analyzed temperature distributions and modeled the hypolimnion heat budget to assess vertical mixing between layers (0.639–3.515 × 10−6 m3 day−1), vertical diffusivity coefficient KZ (2.5 × 10−6–13.6 × 10−6 m2 s−1), and vertical nutrient transport to the epilimnion. Nutrient flux from the metalimnion to the epilimnion ranged 0.42–5.99 mg P m−2day−1 for soluble reactive phosphorus (SRP) and 5.8–101.7 mg N m−2day−1 for dissolved inorganic nitrogen (DIN). Vertical mixing and the associated nutrient fluxes increase evidently as the water level decreases 8 m below capacity, and they can increase up to fivefold if the water level drops over 12 m. The observed changes related to water level affect nutrient recycling, ecosystemic metabolic balance, and planktonic composition of VB.This research was funded by UNAM (PAPIIT-IN207702 and PAPIIT-IN111321) and by CONACYT-SEMARNAT (C01-1125) projects to M.M.-I.Peer reviewe